2019 will bring changes to the individual health insurance market. The mandate and penalty for not being enrolled in Affordable Care Act (ACA) or Obamacare health insurance plans has been eliminated.
This means you will have more choices for coverage outside the ACA. You will be able to select ACA plans or Non-ACA plans that will meet your specific individual needs.
To help you navigate your choices, I have put together a list of four rules you need to remember when considering your health insurance options.
1. NEVER OVERPAY FOR HEALTH INSURANCE – Health insurance is useless unless it is affordable. Don’t pay for a plan with all the mandates if you only need catastrophic coverage.
2. YOU DON’T NEED HEALTH INSURANCE JUST TO GO TO A DOCTOR - Anyone can see a doctor by just paying for an office visit. You need health insurance to pay for hospitals, expensive tests, and high-priced medications.
3. REMEMBER, HEALTH INSURANCE IS A FINANCIAL INSTRUMENT – Health insurance coverage is used to protect your assets like a home, financial assets, or any job where your wages or salary could be attached to pay for your medical bills.
4. UNDERSTAND THE TRUE FINANCIAL RISK OF YOUR HEALTH INSURANCE – When you have a health insurance policy, you have two major financial obligations: your monthly premium and the combined deductible of the policy. Taken together they make up your True Financial Risk.
EXAMPLE OF TRUE FINANCIAL RISK
➙ In 2019, A family of four enrolls in an ACA Silver plan with monthly premium of $1,500. The family will pay $18,000 in yearly premiums.
➙ Bronze and Silver plans both have combined family deductible of at least $14,000, Gold $12,000, and Platinum $6,700.
➙ Adding together the yearly premium of $18,000 and the combined deductible of $14,000, the total TRUE FINANCIAL RISK to the family for their medical expenses will be $32,000.
HOW CAN I PROTECT MY FAMILY AND LOWER MY TRUE FINANCIAL RISK?
- You can add GAP coverage to pay for or reimburse the gap of your combined deductible before the insurance carrier pays the remainder of the medical expenses.
- GAP coverage is a separate policy designed to pay for specific medical expenses such as accidents, hospital admissions and inpatient expenses, and critical illnesses.
WHAT ARE MY OPTIONS FOR 2019?
- ACA plans with all the mandates and the waiver of pre-existing conditions.
- Non-ACA plans like Catastrophic Plans, Healthcare Sharing Ministries (religious and secular), Hospital Indemnity Plans, and certain types of Association Plans.
CAN I ENROLL IN ONE OF THESE PLANS WHENEVER I WANT?
- ACA Plans - No, unless there is a qualifying event, you may only enroll in these plans during Open Enrollment (November 1st to January 31st depending on the state).
- Non-ACA Plans – Yes there are no restrictions as to the time of the year for enrollment.
WHY WOULD SOMEONE ENROLL IN A NON-ACA?
- Not eligible for a federal premium subsidy
- Generally, in good health
- Not able to afford ACA Obamacare health plans
- Just want catastrophic coverage
- Can't enroll in an ACA Plan due to missing open enrollment
WOULD YOU LIKE MORE INFORMATION? PLEASE CALL ME AT 626-689-7654